What is symbrachydactyly?

Hand of a child with short fingers and a typical-size thumb
Hand of a child with short fingers from symbrachydactyly.

Babies with symbrachydactyly (sim-BRA-chi-DAK-til-ee) are born with short fingers, which may be webbed, or they are missing fingers. Usually this happens on only 1 hand, and the other hand looks typical.

Some of the finger bones (, fah-LAN-jeez) may be smaller than is typical, and the fingers may be stiff. In more serious cases, the fingers are missing bones. If the fingers have no bones at all, your baby may have little stumps of skin and  (nubbins) where the fingers would be.

The long bones that connect the fingers to the wrist (metacarpals) may be short too. Some babies have a short forearm as well. The muscles,  and  in the hand are also affected. In addition, the muscles of the chest can sometimes be involved.  

Will my child be able to use their hands?

Most children with this condition can use their hands well enough to do all the usual things children do. Even if their smaller hand doesn’t work well on its own, they can use it to assist their other hand.

What causes symbrachydactyly?

When a baby’s hands begin to form in the womb, they are shaped like mittens or paddles. Then the fingers divide. In babies with symbrachydactyly, the fingers (and sometimes the hand and arm) don’t fully form during this time. This may happen because the area doesn’t get enough blood flow or because of some other problem with the tissue. It’s not caused by anything the parents did or did not do.

How common is symbrachydactyly?

Symbrachydactyly isn’t common. It happens in about 1 in 32,000 babies. It’s not passed down in families (inherited). If you have a child with symbrachydactyly, you are not at any greater risk of having another child with the condition.

Why choose Seattle Children’s for symbrachydactyly treatment?

Seattle Children’s Hand and Upper Extremity Program treats children with symbrachydactyly. We see babies with this condition every year in our clinics. Our team is experienced in the range of treatment options for symbrachydactyly. We create a treatment plan custom-made for your child to get the best results for them.

  • The hand experts you need are here
    • Your child’s team includes doctors, surgeons, and nurses from Orthopedics and Sports Medicine as well as Plastic Surgery if needed.
    • For many of our patients, treatment means surgery — sometimes highly complex surgery — to improve how their hand works and looks. Our surgeons are experienced at doing this type of surgery in children. We have surgeons with expanded fellowship training in upper extremity surgery.
    • If your child needs occupational therapy to gain the best use of their hands, we have the largest team of occupational therapists in the Pacific Northwest who specialize in the care of babies, children, teens and young adults.
    • Some children do best with a prosthesis to replace missing parts of their hand. We have orthotics and prosthetics services onsite at Seattle Children’s.
  • Care from before birth through young adulthood
    • We specialize in caring for kids. This means our experts have the knowledge, training and skills to treat the youngest patients, including babies and young children with short or missing fingers. At Seattle Children’s, your child’s team has special training in the medical, surgical, emotional and social needs of young people.
    • If your child is diagnosed with symbrachydactyly before birth based on an , we offer prenatal consultations to talk with you about your baby’s condition.
    • Babies and children are still developing. When we evaluate your child’s condition, plan their treatment and provide their care, we carefully consider their growth. We think about how growth may affect your child’s hands and forearms over time. We also consider how their hands and forearms may affect the rest of their development and health.
    • We have the largest group of  pediatric radiologists in the Northwest. If your child needs imaging that uses radiation, we use the lowest amount possible (PDF) to make the best image. We have a low-dose radiation X-ray machine, called the EOS. It makes safer full-body images.
  • Support for you and your family
    • We know it can be stressful to have a child with a hand or arm difference and to find the treatment they need. Everyone at Seattle Children’s works to make your experience here as easy as we can on your whole family.
    • Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options.
    • Seattle Children’s supports your family with a range of resources. Our Child Life specialists, Family Resource Center and Guest Services are here to help.
  • Research to improve care
    • Seattle Children’s takes part in the CoULD Registry for congenital upper limb differences. A registry is a place where researchers keep information about people who have a certain condition so they can learn more about it. CoULD connects researchers from children’s hospitals around the country to study treatments and improve life for kids born with arms and hands that aren’t typical.
    • Learn more about current orthopedics research at Seattle Children’s.

What are the symptoms of symbrachydactyly?

Babies with symbrachydactyly may have 1 or more of these:

  • Short fingers in which some bones are smaller than typical or are missing
  • Fingers that are joined or webbed (syndactyly)
  • Nubbins of skin and soft tissue where their fingers would be
  • Short hand bones (metacarpals)
  • Short forearm

How is symbrachydactyly diagnosed?

If your child is born with short or missing fingers, the doctor will examine your child carefully. During the exam, the doctor will check to see how complex the condition is and how it might affect your child’s use of their hand.

Your child may need an  or other type of imaging scan to tell if any phalanges are missing; if the metacarpals are short; and how other tissues, such as muscles and tendons, are affected.

How is symbrachydactyly treated?

Most children with symbrachydactyly can do all the usual things children do because they have enough hand function or gain enough function with treatment.

Mild symbrachydactyly may not need any treatment at all. Some children need , surgery or a to improve use of their hand. Your child’s doctors will work with you to design treatment custom-made for your child’s needs.

Occupational therapy

Occupational therapists (OTs) teach your child skills to take care of themselves, such as how to eat and how to get dressed. They also work with your child to develop fine motor skills, such as writing.

Even if your child’s smaller hand doesn’t work well on its own, your child can use it to assist their other hand. OTs help children learn the best ways to use their hands together.

Many tools (adaptive devices) may help your child do things on their own. OTs suggest these tools and teach your child how to use them.


The main goal of surgery is to improve your child’s ability to grasp and pinch. Surgery may also make your child’s hand look more typical, but it will not look just like a typical hand.

Your child’s team may recommend 1 or more of these treatments if it is likely to improve your child’s function:

  • Surgery to divide webbed fingers. Read more about treatment for syndactyly.
  • Surgery to move their thumb. This may allow your child to pinch objects between a finger and thumb.
  • Distraction. Very rarely, doctors recommend a procedure to make bones longer. This involves cutting through the bone and then using metal pins and rods to move the pieces of bone away from each other slowly over many weeks (a process called distraction). The surgeon fills the gap with a

The timing of surgery varies. Your child’s team will work with you to make a plan based on your child’s needs. After any surgery, the doctor will want your child to come back for follow-up visits to make sure they are healing well.


Prostheses are devices that replace missing body parts. These may be an option to help with the way your child’s hand works or looks.

Contact Us

Contact Orthopedics and Sports Medicine at 206-987-2109 for an appointment, a second opinion or more information.

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